Unstable Angina
Tabor & Whitmore (2018), explain that unstable angina occurs due to an acute obstruction of the coronary artery without myocardial infarction. These patients can present with chest pain/burning, left arm pain/numbness/tingling, angina that becomes more frequent even when resting, shortness of breath and more. In order to properly diagnose angina, it is important to obtain a troponin (if first one is negative may want to repeat in 8-12 hours), a CK-MB level, Chest x-ray, Echocardiogram and a CT chest to ensure the patient is not experiencing a life-threatening aortic dissection. Patients with unstable angina should be admitted to the hospital, given aspirin and Plavix for antiplatelet management and nitroglycerin for the pain if not hypotensive or have not used a phosphodiesterase type 5 inhibitor within 24-48 hours. If the patient is experiencing unstable angina along with an NSTEMI then they need to have a cardiac catheterization performed within 24-48 hours of being admitted into the hospital for and necessary PCI.
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